The medical center sustained severe damage in Monday's deadly tornado, though no patients reportedly died. Two years ago, a tornado heavily damaged St. John's Regional Medical Center in Joplin, Mo., killing four people there. That hospital eventually was demolished.

At Sherman Hospital in Elgin, staff members are alerted of tornado watches and warnings via phone and email blasts, said John Mayer, disaster preparedness coordinator.

When the hospital is determined to be in the path of a tornado, a "code black" is activated to evacuate patients into hallways and other designated safe areas, Mayer said. That might also include evacuating patients from the top floor if roof damage is expected.

"It is very, very labor intensive, especially with people who are hooked up to life monitoring equipment," he said.

Basements are considered the only truly safe place in EF-5, or highest intensity, tornadoes like Monday's, but there just isn't enough time to do that for a 250-bed hospital, Mayer said.

"The logistics of getting everyone to a basement -- it's just not going to happen."

Sherman Hospital conducts twice-yearly drills with actors in the role of adult patients, and dolls to simulate pediatric patients, Mayer said.

"For people that are not mobile, staff is trained to put them on portable slides, and they slide them down the hall to the stairway," he said.

Rehabilitation patients -- who tend to be ambulatory -- take part in yearly drills that include the evacuation of two full floors at Presence St. Joseph Hospital in Elgin, said Al Jensen, assistant vice president of facilities management.

During code black, the main goal is to get patients into safe areas, and away from glass, he said. Drills account for the fact that tornadoes would likely come from the west, he said.

It's also imperative to make sure patients who need it have access to emergency power and medical gases like oxygen, he aid.

The most difficult patients to move are the ones in the intensive care unit, those who are on ventilators, and those who had recent major surgery, he said.

"That would be the assessment we'd have to make as caregivers, to have a plan for relocating on a priority basis," he said.

Both Mayer and Jensen said hospitals across the country learned a lot from the 2011 tornado in Missouri.

"There are many negatives to buildings with a lot of glass and a lot of open stairwells," Mayer said.

"For our industry, that was an-eye opening experience," he said, pointing out most modern hospitals are built like that.

St. Joseph's staff also learned a lot from webinars and written first-person accounts featuring the Joplin hospital staff, Jensen said.

"It was very enlightening," he said. "Expediency is critical. You don't have a lot of time -- as fast as you can say 'code black,' it's on you."

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